Intra-Operative Navigation for Orbital Reconstruction to Correct Diplopia and Enophthalmos with Endoscopic Assisted Technique: First Case Report in Thailand

Lek Kanjanakomut MD*

Affiliation : * Division of Plastic Surgery, Department of Surgery, Rajavithi Hospital, College of Medicine, Rangsit University, Bangkok, Thailand

Background and Objective : In an orbital fracture involving diplopia, enophthalmos is a major problem to be corrected because of soft tissue swelling and limited incision, which causes inaccurate restoration of orbital anatomy and reestablishing orbital volume. Pre-operative computerized planning combined with intra-operative navigation and endoscopy are used to create the accurate anatomical orbital position and effectively correct the posttraumatic diplopia and enophthalmos.
Case Report : An 18-year-old Thai male with diplopia and enophthalmos presented a posttraumatic left orbital fracture two months prior. Three-dimensional CT scan of the facial bone confirmed the fracture. The patient required surgical treatment for correction of the orbital fracture. The intra-operative navigator and endoscopy-assisted technique were used. Pre- and post-operative pictures were compared, indicated the successful correction of enophthalmos and clinical correction of diplopia.
Conclusion : Intra-operative navigator combined with endoscopy-assisted technique were a new surgical procedure that could correct the orbital deformity problem involving enophthalmos and diplopia more effective.

Keywords : Intra-operative navigator, Endoscopy-assisted technique, Enophthalmos, Diplopia, Orbital fraction

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